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Topic:Pain Management

Pain management in horses involves various strategies and interventions designed to alleviate discomfort and improve the well-being of equine patients. It encompasses pharmacological approaches, such as the use of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and other analgesics, as well as non-pharmacological methods like physical therapy, acupuncture, and environmental modifications. Effective pain management aims to address both acute and chronic pain conditions, which can result from injuries, surgeries, or diseases such as laminitis and arthritis. This page aggregates peer-reviewed research studies and scholarly articles that explore the mechanisms, efficacy, and safety of different pain management techniques in horses, contributing to the understanding and advancement of equine veterinary care.
Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses.
Veterinary anaesthesia and analgesia    February 5, 2019   Volume 46, Issue 3 325-334 doi: 10.1016/j.vaa.2019.01.005
Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S.To determine the required rate of a detomidine infusion (loading dose 5 μg kg; initial rate 12.5 μg kg hour) added to a constant infusion of methadone (0.2 mg kg; 0.05 mg kg hour) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. Methods: Prospective, clinical study. Methods: Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. Methods: At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 ...
Letter to the Editor: Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction.
Equine veterinary journal    February 3, 2019   Volume 51, Issue 3 422 doi: 10.1111/evj.13078
Freeman DE.No abstract available
Using Movement Sensors to Assess Lying Time in Horses With and Without Angular Limb Deformities.
Journal of equine veterinary science    January 31, 2019   Volume 75 55-59 doi: 10.1016/j.jevs.2019.01.011
Clothier J, Small A, Hinch G, Barwick J, Brown WY.Chronic musculoskeletal pathologies are common in horses, however, identifying related effects can be challenging. This study tested the hypothesis that movement sensors and analgesics could be used in combination to confirm the presence of restrictive pathologies by assessing lying time. Four horses presenting a range of angular limb deformities (ALDs) and four nonaffected controls were used. The study comprised two trials at separate paddock locations. Trial A consisted of a 3-day baseline phase and 2 × 3-day treatment phases, during which two analgesics were administered to two ALD horses...
Assessing pain in horses.
The Veterinary record    January 27, 2019   Volume 184, Issue 4 124 doi: 10.1136/vr.l385
Gleerup KB.No abstract available
Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial.
Journal of sport rehabilitation    January 25, 2019   Volume 29, Issue 2 179-185 doi: 10.1123/jsr.2018-0252
Kim T, Lee J, Oh S, Kim S, Yoon B.A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Methods: A randomized controlled trial. Methods: Community and university campus. Methods: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Methods: The exercises were performed for 30 minutes, 2 days p...
Intravenous infusion of magnesium sulfate and its effect on horses with trigeminal-mediated headshaking.
Journal of veterinary internal medicine    January 22, 2019   Volume 33, Issue 2 923-932 doi: 10.1111/jvim.15410
Sheldon SA, Aleman M, Costa LRR, Santoyo AC, Howey Q, Madigan JE.Trigeminal-mediated headshaking results from low-threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal-mediated headshaking. Objective: To investigate head-shaking behavior in affected horses after IV magnesium sulfate infusion. Methods: Six geldings with trigeminal-mediated headshaking. Methods: Prospective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextros...
Comparison of three acute colic pain scales: Reliability, validity and usability.
Veterinary journal (London, England : 1997)    January 21, 2019   Volume 246 71-77 doi: 10.1016/j.tvjl.2019.01.004
Sutton GA, Atamna R, Steinman A, Mair TS.A valid, reliable and usable scale is needed for assessing severity of acute abdominal pain in horses. The study aim was to compare three different scales: (1) the equine acute abdominal pain scale (EAAPS); (2) a scale described by Mair and Smith (2005; M and S); and (3) a numerical rating scale (NRS). Forty brief films of horses (35 of colic cases and five of control horses) were randomly presented to 46 equine veterinarians from different countries. Participants, randomly divided into three groups, each used one scale. Five randomly selected films were shown twice for determining intra-obser...
Buffering mepivacaine with sodium bicarbonate speeds and potentiates analgesia of median and ulnar nerve blocks performed on horses.
The Veterinary record    January 19, 2019   Volume 184, Issue 5 155 doi: 10.1136/vr.104962
Boone L, Schumacher J, DeGraves F, Cole R.The objective of this study was to determine if buffering mepivacaine HCL (mepHCl) with sodium bicarbonate (NaHCO3) would significantly decrease the time to onset of analgesia when performing median and ulnar nerve blocks in naturally lame horses. Median and ulnar nerve blocks were performed on the naturally lame limb of nine horses during two separate study periods, with a minimum washout period of three days between study periods. Nerve blocks were performed by administering mepHCl alone or mepHCl mixed with NaHCO3 (nine parts 2 per cent mepHCl to one part 8.4 per cent NaHCO3). Lameness was ...
Trigeminal-mediated headshaking in horses: prevalence, impact, and management strategies.
Veterinary medicine (Auckland, N.Z.)    January 9, 2019   Volume 10 1-8 doi: 10.2147/VMRR.S163805
Roberts V.Trigeminal-mediated headshaking is a little-understood neuropathic facial pain condition of the horse. The condition may affect around 1% of the equine population to a degree of severity sufficient to require veterinary attention. As a pain condition, this represents a significant welfare issue. Horses are usually more severely affected at exercise which can leave them unable to perform, or even dangerous to ride and handle. With little known about the condition and variable response to treatments, severely affected horses are often euthanized. This review article considers the literature on t...
Correction: Effects of intrabursal administration of botulinum toxin type B on lameness in horses with degenerative injury to the podotrochlear apparatus.
American journal of veterinary research    January 4, 2019   Volume 80, Issue 1 78 doi: 10.2460/ajvr.80.1.78
No abstract available
Letter to the Editor: A response to ‘What is lameness and what (or who) is the gold standard to detect it?’.
Equine veterinary journal    December 20, 2018   Volume 51, Issue 2 270-272 doi: 10.1111/evj.13043
Adair S, Baus M, Bell R, Boero M, Bussy C, Cardenas F, Casey T, Castro J, Davis W, Erskine M, Farr R, Fischer A, Forbes B, Ford T, Genovese R....No abstract available
An Objective Assessment of the Effect of Anesthetizing the Median Nerve on Lameness Caused by Pain in the Cubital Joint.
Journal of equine veterinary science    December 19, 2018   Volume 75 9-13 doi: 10.1016/j.jevs.2018.12.008
McGlinchey L, Agne G, Passler T, Cole R, Schumacher J.The median nerve, along with the ulnar nerve, is often anesthetized when performing a lameness examination in horses. Because of the close proximity of the median nerve to the cubital joint, proximal migration of local anesthetic might ameliorate pain originating from the cubital joint. The objective of this study was to determine if a median nerve block will ameliorate lameness caused by pain in the cubital joint. A forelimb lameness was induced in six healthy horses by injecting 100 ng of recombinant equine interleukin 1 beta (IL-1β) into the cubital joint. The median nerve of the lame leg...
Intra-articular Corticosteroids for Knee Pain-What Have We Learned from the Equine Athlete and Current Best Practice.
The journal of knee surgery    December 18, 2018   Volume 32, Issue 1 9-25 doi: 10.1055/s-0038-1676449
McIlwraith CW, Lattermann C.The use of intra-articular corticosteroids for traumatic arthritis and osteoarthritis (OA) is common in the horse. The beneficial and deleterious effects of the principal corticosteroids used betamethasone esters (Celestone [Soluspan], methylprednisolone acetate [Depo Medrol], and triamcinolone acetonide [TA] [Vetalog or Kenalog]) have been defined for the horse. While TA has both disease-modifying as well as symptom-modifying effects, methyl prednisolone acetate has deleterious effects on the articular cartilage. Studies in traumatically injured joints show the same rationale (suppression of ...
Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses.
Equine veterinary journal    December 18, 2018   Volume 51, Issue 4 530-536 doi: 10.1111/evj.13054
Gozalo-Marcilla M, de Oliveira AR, Fonseca MW, Possebon FS, Pelligand L, Taylor PM, Luna SPL.Standing surgery avoids the risks of general anaesthesia in horses. Objective: To assess sedation, antinociception and gastrointestinal motility in standing horses after a detomidine loading dose and 2-h constant rate intravenous (i.v.) infusion, with or without methadone. Methods: Blinded, randomised, crossover with seven healthy adult cross-bred horses, three geldings and four females (404 ± 22 kg). Methods: Five i.v. treatments were administered to all horses with 1-week washout period: saline (SAL), detomidine low (2.5 μg/kg bwt + 6.25 μg/kg bwt/h) (DL) and high doses (5 μg/kg ...
Histological examination of the interspinous ligament in horses with overriding spinous processes.
Veterinary journal (London, England : 1997)    December 12, 2018   Volume 244 69-74 doi: 10.1016/j.tvjl.2018.12.012
Ehrle A, Ressel L, Ricci E, Merle R, Singer ER.The equine interspinous ligament (ISL) consists of an oblique crossing arrangement of collagenous bundles which are thought to counteract the tensile and rotational forces of distraction between the spinous processes (SPs) in the caudal thoracic and cranial lumbar spine. The aim of this controlled histological study was to assess the structural anatomy and innervation of the ISL in horses with clinically significant overriding (dorsal) SPs (ORSPs) and to compare the findings with the ISL of normal horses. Samples of the ISL were obtained from 10 horses that underwent subtotal ostectomy for tre...
The pharmacokinetics and pharmacodynamics of intravenous hydromorphone in horses.
Veterinary anaesthesia and analgesia    November 22, 2018   Volume 46, Issue 3 395-404 doi: 10.1016/j.vaa.2018.11.001
Reed R, Barletta M, Mitchell K, Hanafi A, Bullington A, Knych H, Quandt J, Ryan C, Giguère S.Describe the pharmacokinetics and pharmacodynamics of intravenous hydromorphone in healthy horses. Methods: Masked, randomized, cross-over, Latin square design. Methods: A group of eight healthy adult horses METHODS: Horses were administered each of four treatments with an 8 day washout. Treatments groups included intravenous hydromorphone 0.02 mg kg (LD), 0.04 mg kg (MD), 0.08 mg kg (HD) and saline (P). Blood samples for hydromorphone analysis were obtained for 24 hours after treatment. Plasma hydromorphone was quantified and pharmacokinetic parameters were determined using non-compartmental ...
Quantitative assessment of intravenous regional limb perfusion of tiludronate as an adjunctive treatment for lameness caused by navicular syndrome in horses.
American journal of veterinary research    November 21, 2018   Volume 79, Issue 12 1313-1320 doi: 10.2460/ajvr.79.12.1313
Schoonover MJ, Whitfield CT, Young JM, Sippel KM, Payton ME.OBJECTIVE To determine effects for 2 IV regional limb perfusion (IVRLP) protocols involving tiludronate on lameness of horses with navicular syndrome. ANIMALS 15 horses with bilateral forelimb navicular syndrome. PROCEDURES Shoeing and anti-inflammatory injection into the distal interphalangeal joint (DIPJ) of both forelimbs (day 0) were performed on all horses. On day 14, horses received 1 of 3 IVRLPs consisting of 0.1 mg of tiludronate/kg (low-dose tiludronate [LDT]; n = 5), 0.2 mg of tiludronate/kg (high-dose tiludronate [HDT]; 5), or saline (0.9% NaCl) solution (placebo; 5); treatments wer...
Equine Wounds over Synovial Structures.
The Veterinary clinics of North America. Equine practice    November 19, 2018   Volume 34, Issue 3 575-590 doi: 10.1016/j.cveq.2018.07.002
Ludwig EK, van Harreveld PD.Equine septic synovitis commonly occurs secondary to traumatic wounds. The distal limbs of horses have minimal soft tissue protection, thus wounds in these areas are more likely to involve adjacent synovial structures. Synovial sepsis can be debilitating due to difficulties clearing established infections and the degenerative changes that result from ongoing inflammation. Prompt diagnosis allows for immediate treatment, improving the prognosis. Goals for successful treatment of infected synovial structures due to wounds include early and accurate recognition of the condition, rapid resolution ...
Characterisation of the in vivo interactions between detomidine and methadone in horses: Pharmacokinetic and pharmacodynamic modelling.
Equine veterinary journal    November 17, 2018   Volume 51, Issue 4 517-529 doi: 10.1111/evj.13031
Gozalo-Marcilla M, Luna SPL, Moreira da Silva R, Crosignani N, Lopes NP, Taylor PM, Pelligand L.Pharmacokinetic (PK)/pharmacodynamic (PD) modelling offers new insights to design protocols for sedation and analgesia in standing horses. Objective: To evaluate the parameters and interactions between detomidine and methadone when given alone or combined in standing horses. Methods: Randomised, placebo-controlled, blinded, crossover. Methods: Eight adult healthy horses were given six treatments intravenously: saline (SAL); detomidine (5 μg/kg bwt; DET); methadone (0.2 mg/kg bwt; MET) alone or combined with detomidine (2.5 [MLD], 5 [MMD] or 10 [MHD] μg/kg bwt). Venous blood samples were ob...
Thoracic processi spinosi findings agree among subjective, semiquantitative, and modified semiquantitative scintigraphic image evaluation methods and partially agree with clinical findings in horses with and without thoracolumbar pain. van Zadelhoff C, Ehrle A, Merle R, Jahn W, Lischer C.Impinging processi spinosi in the equine thoracic spine are a common cause of poor performance in the horse. A modified semiquantitative scintigraphic image analysis has been proposed for the evaluation of equine processi spinosi. This technique showed a high inter- and intraobserver agreement when compared to subjective and semiquantitative image analysis. The aim of this retrospective, method comparison study was to evaluate the agreement of the modified semiquantitative scintigraphic image assessment with previous methods of interpretation and to compare these scintigraphic evaluation techn...
Diagnosing and treating laminitis in horses.
The Veterinary record    October 27, 2018   Volume 183, Issue 16 505-506 doi: 10.1136/vr.k4485
Menzies-Gow N.No abstract available
Objective pain assessment in horses (2014-2018).
Veterinary journal (London, England : 1997)    October 9, 2018   Volume 242 1-7 doi: 10.1016/j.tvjl.2018.10.001
van Loon JPAM, Van Dierendonck MC.In recent decades, much effort has been invested in scientific studies of objective and reliable assessment of pain in horses. Various types of pain assessment tools have been described and (partly) validated for different types of pain in horses. Currently, composite pain scales and facial expression-based pain scales seem to be the most promising tools for pain assessment in horses and numerous studies have recently been published on the use of these pain scales in horses. Therefore, this narrative review mainly focusses on these two types of pain scales and on the studies that have appeared...
Bone Marrow Aspiration Does Not Induce a Measurable Pain Response Compared to Sham Procedure.
Frontiers in veterinary science    October 1, 2018   Volume 5 233 doi: 10.3389/fvets.2018.00233
Rowland AL, Navas de Solis C, Lepiz MA, Cummings KJ, Watts AE.Bone marrow is commonly collected from horses for regenerative medicine applications. Little information is available regarding pain experienced by the horse during bone marrow aspiration. The objective of this study was to characterize horse reaction and pain response during bone marrow aspiration (BMA) compared to a sham (SHAM) procedure. We hypothesized there would be significantly greater horse reaction or pain response measured by salivary cortisol, heart rate variability, and depth and duration of sedation between BMA and SHAM. Twelve university owned horses underwent a BMA and sham proc...
Effect of the addition of epinephrine to a lidocaine solution on the efficacy and duration of palmar digital nerve blocks in horses with naturally occurring forefoot lameness.
American journal of veterinary research    September 27, 2018   Volume 79, Issue 10 1028-1034 doi: 10.2460/ajvr.79.10.1028
Alvarez AV, Schumacher J, DeGraves FJ.OBJECTIVE To determine whether addition of epinephrine to a lidocaine solution would prolong and potentiate the efficacy of a palmar digital nerve block (PDNB) in horses. ANIMALS 6 adult horses with naturally occurring forefoot lameness. PROCEDURES Initially, a PDNB with a 2% lidocaine solution was performed on the affected foot of each horse. Three days later, the PDNB was repeated with a 1% lidocaine solution or a 1% lidocaine solution containing epinephrine (dilution, 1:200,000). After another 3-day washout period, the PDNB was repeated with the treatment opposite that administered for the ...
Plasma and synovial fluid concentrations and cartilage toxicity of bupivacaine following intra-articular administration of a liposomal formulation to horses.
Equine veterinary journal    September 25, 2018   Volume 51, Issue 3 408-414 doi: 10.1111/evj.13015
Knych HK, Mama KR, Moore CE, Hill AE, McKEMIE DS.The use of intra-articular (IA) local anaesthetics has proven to be an effective means to treat post-operative pain. The effects of local anaesthetics on equine chondrocytes are mixed with some studies reporting chondrodestruction and others no adverse effects. A liposomal formulation of bupivacaine is used in people and dogs by intra- and peri-articular administration to provide up to 72 h of analgesia. The potential uses, side effects including chondrotoxicity, and likelihood of abuse (long-term analgesic effects) has not been evaluated in horses. Objective: Describe bupivacaine concentrati...
Clodronate improves lameness in horses without changing bone turnover markers.
Equine veterinary journal    September 22, 2018   Volume 51, Issue 3 356-363 doi: 10.1111/evj.13011
Mitchell A, Wright G, Sampson SN, Martin M, Cummings K, Gaddy D, Watts AE.Clodronate is prescribed to performance horses with lameness. Despite its clinical popularity, little research has been done to understand the effects of clodronate in the horse. Objective: Our objective was to determine if a single treatment with clodronate at the clinically approved dose altered bone remodelling, bone cell recruitment or lameness in the horse. Methods: Twelve university-owned equestrian team competition horses with a history of forelimb lameness due to navicular syndrome were randomised to receive either 1.4 mg/kg clodronate (CLOD n = 6) or an equivalent volume of LRS (CONT;...
Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction.
Equine veterinary journal    September 21, 2018   Volume 51, Issue 3 329-335 doi: 10.1111/evj.13013
Ziegler AL, Freeman CK, Fogle CA, Burke MJ, Davis JL, Cook VL, Southwood LL, Blikslager AT.Small intestinal strangulating obstruction (SISO) is associated with endotoxaemia which leads to an increased risk of death. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat signs of endotoxaemia by inhibiting cyclo-oxygenases (COX). COX-1 is expressed constitutively and promotes gut barrier function, whereas COX-2 is inducible and contributes to the signs of endotoxaemia. In preclinical SISO trials, intestinal barrier recovery was more complete with reductions in endotoxin permeability in horses treated with COX-2 selective NSAIDs as compared with horses treated with flunixin m...
How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm.
Veterinary anaesthesia and analgesia    September 19, 2018   Volume 46, Issue 1 4-13 doi: 10.1016/j.vaa.2018.08.005
Schauvliege S, Cuypers C, Michielsen A, Gasthuys F, Gozalo-Marcilla M.To summarize the different methods used to assess sedation and/or adjust the dose or administration rate of alpha-2 agonists in horses and to propose an algorithm to adjust the administration rate of a constant rate infusion of an alpha-2 agonist in horses. Methods: PubMed and Web of Science; search terms: horse, sedation and score. Conclusions: Most authors distinguish between sedation depth, sedation quality and degree of ataxia. These three features are evaluated using scoring systems similar to those classically used to assess pain, i.e. simple descriptive scales, numerical rating scales (...
Colon constipation in horses after sustained-release buprenorphine administration.
Veterinary anaesthesia and analgesia    September 11, 2018   Volume 45, Issue 6 876-880 doi: 10.1016/j.vaa.2018.08.004
Levionnois OL, Graubner C, Spadavecchia C.To investigate the pharmacological profile and side effects of buprenorphine administered as a sustained-release formulation in horses. Methods: Pilot trial. Methods: A total of four experimental horses, aged 18-27 years and weighing 508-578 kg. Methods: Buprenorphine (0.1 mg kg) was mixed as a freshly prepared sterile solution with a sustained-release drug carrier. It was administered by the subcutaneous (n = 2) or intramuscular (n = 2) route. During the experiment, the horses were closely monitored, equipped with a step counter and blood samples were collected for quantification of bup...
Disease-Modifying Osteoarthritis Treatment With Interleukin-1 Receptor Antagonist Gene Therapy in Small and Large Animal Models.
Arthritis & rheumatology (Hoboken, N.J.)    September 10, 2018   Volume 70, Issue 11 1757-1768 doi: 10.1002/art.40668
Nixon AJ, Grol MW, Lang HM, Ruan MZC, Stone A, Begum L, Chen Y, Dawson B, Gannon F, Plutizki S, Lee BHL, Guse K.Gene therapy holds great promise for the treatment of osteoarthritis (OA) because a single intraarticular injection can lead to long-term expression of therapeutic proteins within the joint. This study was undertaken to investigate the use of a helper-dependent adenovirus (HDAd)-mediated intraarticular gene therapy approach for long-term expression of interleukin-1 receptor antagonist (IL-1Ra) as sustained symptomatic and disease-modifying therapy for OA. In mouse models of OA, efficacy of HDAd-IL-1Ra was evaluated by histologic analysis, micro-computed tomography (micro-CT), and hot plate ana...
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